Sepsis: Blood and Fluid Resuscitation

To define the disease known as sepsis, briefly discuss its pathophysiology, etiology, signs, symptoms, and treatments. Outline protocols for sepsis screening, early directed goal therapy, and to establish the nurse’s role in the process. Sepsis is a complex disease, or response to a disease process that can lead to patient mortality rates up to 60%. Gram negative infectious organisms invade the blood stream, and activate a systemic response. This systemic response exacerbates the problem, leading to disproportionate blood flow, alterations in tissue perfusion, and eventually multiple organ failure. Sepsis screening begins in the ER, signs and symptoms that are indicative of sepsis, or early indications of infection that can eventually lead to sepsis should be identified quickly. Since the majority of these patients are already compromised, it is imperative to have proper screening and initiate early goal directed therapy. Following standard protocols has proven to reduce mortality rates by as much as 25%. Sepsis; pathophysiology, etiology and treatment

Sepsis has been defined as a suspected or proven infection that has entered the blood stream, and has the clinical manifestations of what has been termed the systemic inflammatory response (e.g., fever, tachycardia, hypotension, and elevated white blood cell count termed leukocytosis) (Dellacroce, 2009, p. 17). Sepsis can be a result of any infection in the body that has triggered this systemic inflammatory response. Often times especially in the elderly it might be a result of an untreated urinary tract infection, or some other unknown infection that enters into the blood stream. When the invading organism or antigen enters the bloodstream, it releases endotoxins, a toxic substance usually associated with gram negative bacteria, such as Escherichia coli, Klebsiella pneumoniae, Serratia, Enterobactor, and Pseudomonas. In the patient who is ill...

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Sepsis
Becky Winzentsen
Bryant & Stratton College
AHLT 120 – A&P
Dr. Mark Decker
April 2, 2014
I chose to write about sepsis because my mother passed away from this deadly disease on March 9th. She was admitted to West Allis Memorial Hospital on February 25th with a severe urinary tract infection (UTI). My father and I thought she had a stroke because she showed signs of weakness, slurring, lethargy, and confusion. The doctors indicated that there was no sign of stroke, which was a relief. She was then admitted overnight for treatment of her UTI. Four days later on February 29th, she was moved into ICU because she continued to have the same symptoms and appeared to be getting worse. After doing my own research on her symptoms, I asked the ICU nurse if they tested her for sepsis. She confirmed that she did have sepsis and they were now treating that along with a laundry list of other things. Eight days later, my mother passed away from complications of: Sepsis, COPD, Pneumonia, Hypoxia, Klebsiella, and Hypercapnia (carbon-dioxide poisoning).
Sepsis is a condition that can be a cause or result of other diseases and infections. Wayne Robson and Ron Daniels (2013) quote the definition as:
Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissue and organs. Sepsis can lead to...

...Running Head: Sepsis
1
Sepsis:
A Clinical Case Study
Example
Conestoga College
Running Head: Sepsis
2
Abstract
Sepsis is an inflammatory systemic response to infection. The symptoms are
produced by the host’s defense systems rather than by the invading pathogens (Schouten
et al., 2008). Sepsis is a frequent cause of admission to intensive care units (ICUs) and it
is one of the leading causes of death among hospitalized patients (Alberti et al., 2003). It
is a public health concern and it continues to be a burden on the healthcare system (Ely,
Kleinpell and Goyette, 2003). Despite advancing medical technology, the rate of patients
in intensive care units diagnosed with sepsis is continually increasing. According to
Schmidt and Mandel (2009), even when optimal treatment is provided, morbidity due to
severe sepsis or septic shock is approximately 40 percent and can exceed 50 percent in
the most critically ill patients. Early recognition of sepsis and sepsis-associated infections
is essential to treating and controlling it from escalating to advanced stages that are
associated with higher mortality rates (Lukaszewski et al., 2008). Unlike other diseases or
trauma, the initial signs and symptoms of sepsis are subtle and can easily be missed by
health care practitioners.
Sepsis involves the...

...undertaking a placement in an acute setting. This portfolio of evidence will be based on a patient diagnosed with sepsis secondary to her chest infection. I will discuss extensively the aetiology, pathophysiology and clinical features of a patient presenting with sepsis treated in an acute care setting.
I will explore the role of the different healthcare professionals that were involved in the care of the patient describing how they contributed to her holistic care. I will incorporate evidence base supporting the approach used by the doctors, nurses and microbiologists in the diagnosing and caring for the patient.
I will equally evaluate practice using findings from contemporary research policy and practice on the care of the adult with acute care needs.
I will also discuss the value of our practice in accordance with professional, ethical and legal frameworks that ensure the privacy of the patient’s interest and well-being. Finally, I will conclude by summarising this portfolio of evidence in relation to acute care practices and focus on identifying my future learning needs in developing myself personally and my professional practice.
It is indicated by Latto (2011) that a meeting between The American College of Chest Physicians and the Society of Critical Care Medicine in 1991 brought about the use of systemic inflammatory response syndrome (SIRS) to define sepsis. SIRS being manifestation of two or more of certain medical...

...1.0 Definitions of Sepsis
!
Sepsis is often referred to as either blood poisoning or septicaemia. Sepsis occurs when
an infections spreads through the blood, causing symptoms to develop throughout the
whole body. It is where the body’s defence mechanisms respond to an infection in some
part of the body which resulting in symptoms such as fever, hypothermia, heart rate
greater than 90 beats per minute, altered mental status, swelling of the extremities, and
high blood glucose in diabetic patients. The criteria used to diagnose sepsis are abnormalities of body temperature, pulse, respirations, and white blood cell counts. When sepsis is
associated with one or more organ dysfunctions, it is referred as severe sepsis. Organ
dysfunction can be defined as acute lung injury; coagulation abnormalities; thrombocytopenia; altered mental status; renal, liver, or cardiac failure; or hypo-perfusion with lactic
acidosis. Septic shock is defined as sepsis-induced hypotension with lower than 90 mm
Hg or reduction by 40 mm Hg or more from baseline in the absence of other causes, persisting despite adequate fluidresuscitation, along with signs of organ hypo-perfusion, such
as lactic acidosis, oliguria, or acute alteration in mental status. The transition from sepsis
to septic...

...﻿1. Using diagrams and/or graphs, explain the following terms:
a. Pressure Head
pressure head [′presh·ər ‚hed]
(fluid mechanics)
Also known as head.
The height of a column of fluid necessary to develop a specific pressure.
The pressure of water at a given point in a pipe arising from the pressure in it.
b. Total Discharge Head
Total discharge head refers to the actual physical difference in height between the liquid level in the pit and the highest point of the discharge pipe or water level in the outlet.
c. NPSH
Net Positive Suction Head (NPSH). The measurement of liquid pressure at the pump end of the suction system, including the design of the pump.
d. Suction Lift
Pump Performance Curve
The pump characteristic is normally described graphically by the manufacturer as a pump performance curve. The pump curve describes the relation between flow rate and head for the actual pump. Other important information for proper pump selection is also included – efficiency curves, NPSHr curve, pump curves for several impeller diameters and different speeds, and power consumption.
Increasing the impeller diameter or speed increases the head and flow rate capacity - and the pump curve moves upwards.
The head capacity can be increased by connecting two or more pumps in series, or the flow rate capacity can be increased by connecting two or more
e. Pump Efficiency
Pump Efficiency
The term pump efficiency is used on all types of pumps to...

...1. Identify each of the following statements as either true or false. If false, explain why.
(a) Viscosity is a measure of how easily a fluid flows.
(b) Although important, fluids are not essential to many living things.
(c) A meniscus forms when water particles adhere to the sides of their container.
(d) Buoyancy, like water pressure, acts in all directions.
2. Describe the relationship between mass, volume, and density of matter.
3. Use the particle theory to explain the differences between solids, liquids, and gases.
4. Comment on the accuracy of the statement below. Describe some exceptions to the statement if there are any. In general, solids are denser than liquids, and liquids are denser than gases.
5. Use the particle theory to explain why changing the temperature of a fluid can also change its density.
6. The density of a fluid usually decreases as the temperature rises. Explain how the behaviour of water differs from this pattern.
7. What is a hydrometer and what is it used for? Describe how to use a hydrometer.
8. Do hydrometers float higher in liquids that are denser or less dense? Make a Summary At the start of this unit; you created a table with some classmates to activate your knowledge of fluids (what they are, where they are found, how they are used, and some harmful effects of and to fluids). You have also developed a concept map as you worked through the...